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Cerebrospinal fluid parameters of B cell-related activity in patients with active disease during natalizumab therapy


Harrer, A; Tumani, H; Niendorf, S; Lauda, F; Geis, C; Weishaupt, A; Kleinschnitz, C; Rauer, S; Kuhle, J; Stangel, M; Weber, F; Uhr, M; Linnebank, M; Wildemann, B; Jarius, S; Guger, M; Ayzenberg, I; Chan, A; Zettl, U; Wiendl, H; Pilz, G; Hitzl, W; Weber, J; Kraus, J (2013). Cerebrospinal fluid parameters of B cell-related activity in patients with active disease during natalizumab therapy. Multiple Sclerosis Journal, 19(9):1209-1212.

Abstract

Recently, the disappearance of oligoclonal bands (OCBs) from the cerebrospinal fluid (CSF) of a few natalizumab-treated patients with multiple sclerosis (MS) has been reported. This is interesting since CSF-restricted OCB are believed to persist in MS. We pooled CSF data from 14 MS centers to obtain an adequate sample size for investigating the suspected changes in central nervous system (CNS)-restricted humoral immune activities in the context of natalizumab therapy. In a retrospective chart analysis, CSF parameters of blood-CSF barrier integrity and intrathecal IgG production from 73 natalizumab-treated MS patients requiring a diagnostic puncture for exclusion of progressive multifocal leukoencephalopathy were compared with CSF data obtained earlier in the course of disease before natalizumab therapy. At the time of repeat lumbar puncture, local IgG production (according to Reibergram) was significantly reduced (p < 0.0001) and OCB had disappeared in 16% of the patients. We therefore conclude that natalizumab therapy interferes with intrathecal antibody production at least in a significant number of patients.

Abstract

Recently, the disappearance of oligoclonal bands (OCBs) from the cerebrospinal fluid (CSF) of a few natalizumab-treated patients with multiple sclerosis (MS) has been reported. This is interesting since CSF-restricted OCB are believed to persist in MS. We pooled CSF data from 14 MS centers to obtain an adequate sample size for investigating the suspected changes in central nervous system (CNS)-restricted humoral immune activities in the context of natalizumab therapy. In a retrospective chart analysis, CSF parameters of blood-CSF barrier integrity and intrathecal IgG production from 73 natalizumab-treated MS patients requiring a diagnostic puncture for exclusion of progressive multifocal leukoencephalopathy were compared with CSF data obtained earlier in the course of disease before natalizumab therapy. At the time of repeat lumbar puncture, local IgG production (according to Reibergram) was significantly reduced (p < 0.0001) and OCB had disappeared in 16% of the patients. We therefore conclude that natalizumab therapy interferes with intrathecal antibody production at least in a significant number of patients.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:06 Dec 2012 12:34
Last Modified:05 Apr 2016 16:06
Publisher:SAGE Publications
Series Name:Multiple Sclerosis
ISSN:1352-4585
Publisher DOI:https://doi.org/10.1177/1352458512463483
PubMed ID:23093485

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